Shifting the Paradigm: Primary Prevention of Sexual Violence
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1 Shifting the Paradigm: Primary Prevention of Sexual Violence NYSCHA/NECHA 2007 Annual Meeting Saratoga Springs, NY October 12, 2007 Presenters: Terri B. Kersch, MS, CHES, CPP, Rensselaer Polytechnic Institute Robert L. Ward, MSEd, ACHA National Office
2 How Did We Get Here Today and Why? CDC (RFA #05040) Enhancing Healthcare Providers Ability to Prevent Sexual Violence (released July 05) National Center for Injury Prevention and Control Division of Violence Prevention Awarded September 1, for two years: 9/1/05 8/31/07
3 American College Health Association Enhancing College and University Healthcare Providers Ability to Prevent Sexual Violence Principal Investigator: Robert L. Ward, MSEd ACHA National Office
4 ACHA/CDC Cooperative Agreement #05040 Consultant Expert Panel: Joetta L. Carr, PhD, Western Michigan University Donna M. Barry, RN, APN-C, FN-CSA, Montclair State University Eric R. Buhi, PhD, MPH, CHES, University of South Florida Theresa B. Kersch, MS, CHES, CPP, Rensselaer Polytechnic Institute
5 CDC CA #05040 Overall Purpose Support the creation of education and support materials that address sexual violence prevention.with a primary emphasis on (Licensed) Healthcare Providers to address sexual violence prevention
6 CDC CA #05040 Specific Purposes PRIMARY prevention activities stopping sexual violence victimization or perpetration before it occurs Expand an association s role in addressing the prevention of sexual violence Conduct organizational assessments to determine the understanding of the impact of sexual violence Develop tools, educational materials, and/or trainings based upon organizational assessments
7 ACHA s Cooperative Agreement Goal A: Conduct two assessments of ACHA members (baseline and follow-up) Goal B: Develop primer document (ACHA Statement/Guidelines) to educate ACHA members on the impact of sexual violence Goal C: Develop and disseminate an educational toolkit
8 Goal A: ACHA Preventing Sexual Violence Member Survey Purpose: Assess member knowledge and attitudes regarding sexual violence and prevention (pre-toolkit and post-toolkit) Categories of knowledge assessed: a. Campus experiences b. Activities c. Opinions d. Knowledge
9 Goal B: Develop Primer Document Develop primer document ACHA Position Statement on Preventing Sexual Violence on College and University Campuses Statement to educate ACHA members on the definition of primary prevention and impact of sexual violence Present Statement at ACHA meetings and workshops Distribute widely to ACHA affiliates and other student affairs associations Use statement as foundation for toolkit
10
11 Goal C: Develop and Disseminate Toolkit on Primary Prevention of Sexual Violence Toolkit to include: Definition and discussion of primary prevention Scope of problem Results from baseline survey ACHA Statement Sample intake forms: written and verbal questions Bystander Intervention Resource lists WHAT ELSE??
12 Contact Info Robert L. Ward, M.S. Project Director American College Health Association P.O. Box Baltimore, MD (410) , x212 (410) fax
13 Preventing Sexual Violence Objectives Describe the Continuum of Sexual Violence The Public Health Approach to Prevention The WHAT and WHEN of Prevention Primary Prevention of Campus Rape What Can We Contribute in Our Roles? NOTE: ACHA would like to thank the National Sexual Violence Resource Center (NSVRC) for the use of many of the slides covered here.
14 What is Prevention? What is Prevention? The systematic process that promotes healthy environments and behaviors and reduces the likelihood or frequency of an incident, condition, or injury occurring. Source: Prevention Institute,
15 Continuum of Sexual Violence Death Sexual & Genital Mutilation Rape Unwanted Sexual Touch Unwanted Physical Touch Invasions of Space & Harassment Sexism Attitudes and Beliefs
16 Public Health Approach Address entire continuum of violence Create a campus violence prevention program All campus constituents collaborate Focus on Perpetrator Patterns Infuse into curricular and co-curricular life Administrators, faculty, & staff coordinate with local community Change policies, practices, infrastructure, & cultures promoting or tolerating violence
17 Preventing Sexual Violence The Difference Between OUTREACH and PREVENTION: OUTREACH refers to activities which raise awareness of the scope and impact of sexual violence. PREVENTION strategies focus on changing the underlying conditions that allow sexual violence to occur.
18 Preventing Sexual Violence The Public Health Approach to Prevention Source: Sexual Violence Prevention: Beginning the Dialogue by Centers for Disease Control and Prevention, Identify Risk and Protective Factors Develop and Test Prevention Strategies Disseminate Effective Strategies and Ensure Widespread Adoption Define the Problem
19 Preventing Sexual Violence: The Public Health Approach Define the Problem Data can provide answers as to how much and where sexual violence is happening. Data sources criminal justice system, ER, rape crisis centers, general public surveys.
20 RAPE IN THE IVORY TOWER Rape IS #1 Crime in college All college women at risk Only 5% report to police 350 rapes per 10,000 students per academic year 90% victims know their perpetrator High risk periods first few months of first year
21 Preventing Sexual Violence: The Public Health Approach Identify Risk and Protective Factors Risk Factor: Anything that increases the likelihood of a person becoming a victim or perpetrator. Protective Factor: Anything that decreases the likelihood of a person becoming a victim or perpetrator.
22 Risk Factors Male Peer Support for Coerced Sex Hypermasculinity Sexism and Misogyny Male Entitlement to Sex Alcohol Abuse Gender Role Rigidity Weak Sanctions Against Rape What Else?
23 Protective Factors Conscious sex Between consenting partners Not coerced or pressured Communicates affection and care Both freely participate Does not objectify women Is not manipulative What else?
24 Preventing Sexual Violence: The Public Health Approach Develop and Test Prevention Strategies Data gathered from those who have worked with various groups can help to design effective prevention programs. Information should be gathered during program implementation. Programs should undergo evaluation before they are widely disseminated.
25 ACHA Preventing Sexual Violence Survey Purpose: Assess ACHA member knowledge and attitudes. Re: sexual violence and prevention (pre-toolkit and post-toolkit) Categories of knowledge assessed: a. Campus Experiences b. Activities c. Opinions d. Knowledge
26 Preventing Sexual Violence: The Public Health Approach Disseminate Effective Strategies and Ensure Widespread Adoption Effective prevention strategies should be adopted and implemented in a variety of settings and should replace ineffective strategies. Dissemination techniques include: training, networking, technical assistance, and outcome evaluation to assess the effectiveness of strategies with new populations.
27 Preventing Sexual Violence: WHEN Do We Intervene? The Prevention Continuum: Primary Secondary Tertiary Approaches that Immediate responses Long-term responses take place AFTER violence has AFTER violence to BEFORE violence occurred to deal with deal with the lasting has occurred to the consequences in consequences and prevent initial the short-term treatment interventions perpetration or victimization Source: Prevention Institute,
28 Is it BEFORE or AFTER? BEFORE Change conditions that support violence Promote conditions that inhibit violence Develop skills for behaviors you want adopted AFTER Respond to violence Provide services to survivors Encourage awareness of the extent of the problem and where to receive services
29 Preventing Sexual Violence Primary Prevention = Moving Upstream to prevent tragedies from occurring downstream. Source: Sexual Violence Prevention: Beginning the Dialogue by Centers for Disease Control and Prevention, 2004.
30 Preventing Sexual Violence: WHAT Is The Focus? In order to prevent sexual violence, we need to understand the circumstances and factors that influence its occurrence.
31 Preventing Sexual Violence Primary Prevention Strategies: Empowering women and girls Bystander intervention Engaging youth as agents of change Healthy relationships Healthy sexuality Challenging male stereotypes and gender roles
32 COLLEGE RAPE CULTURE A DANGEROUS MIX Male peer support Ability to get away with rape Weak sanctions Strong sports culture All male groups & peer pressure Persistent alcohol abuse Sexist images & language prevail Hypermasculinity & sexism
33 The Ecological Model Source: Sexual Violence Prevention: Beginning the Dialogue by Centers for Disease Control and Prevention, The Ecological Model allows us to look at risk and protective factors from multiple domains.
34 The Ecological Model Individual Individual level influences are biological and include personal history factors that increase the likelihood that a person will become a victim or perpetrator.
35 The Ecological Model - Relationship Relationships with peers, intimate partners, and family members can shape a person s behavior and range of experience.
36 The Ecological Model - Community A person s experiences and relationships with their community and social environments, including schools, workplaces, and neighborhoods.
37 The Ecological Model Societal Larger, macro-level factors that influence sexual violence gender inequality, societal norms, etc.
38 PREVENTING RAPE ON CAMPUS Identify social norms that support sexual violence Strengthen sense of community Target entire community Link to alcohol campaigns Use peer educators Role modeling is crucial
39 PREVENTING RAPE ON CAMPUS Entire community has a stake Support bystander behavior Teach skills to intervene Obtain commitment to intervene Teach how to interrupt a possible sexual assault Reduce defensiveness
40 The Ecological Model supports a comprehensive public health approach that not only addresses an individual s risk factors, but also the norms, beliefs, and social and economic systems that create the conditions for the occurrence of sexual violence. Source: Sexual Violence Prevention: Beginning the Dialogue by Centers for Disease Control and Prevention, 2004.
41 A CULTURE OF CARING Cultural shift on campus Promote civility & respect Do the right thing We are all responsible Challenge prevailing norms Change the conversation sex Good sex is consensual sex Responsibility for consent lies with the initiator of sex
42 WHOSE JOB IS IT TO PREVENT RAPE & WHO HAS THE POWER? How to get buy-in from the top Identify key stakeholders Institutional mandates How do colleges benefit? Persuading key administrators Identifying early adopters Unexpected messengers
43
44 WHAT IS TO BE DONE? Assess campus culture & norms Focus on consent Redefine norms for sexuality Reframe our messages Disseminate messages of healthy sexuality to campus communities Infuse into all segments of campus Use cutting edge strategies Teach bystanders how to intervene Implement strong sanctions for violating student code
45 ACHA Campus Violence Committee Recommendations Offer alcohol and smoke-free residence halls Build a sense of community Enforce codes of conduct Implement tougher sanctions Zero tolerance policy for campus violence Review the handling of rape cases Disclose registered sex offenders on campus
46 Innovative Program/Promising Practices Social Norms Programs Mentors in Violence Prevention Community Health Theater Bystander Interventions Teach college men about gender Peer education model Rape prevention for men only
47 Opportunities Prevention Activities in Campus Healthcare Visits 1. STI Testing 2. Gynecology Exams 3. Pregnancy Testing 4. Emergency Contraception Request 5. Birth Control Request 6. Genital Infections 7. Alcohol-related Visits 8. Immunizations 9. Sports Physicals 10. Triage
48 Opportunities for Sexual Assault Prevention Beyond the Office a. b. c. d. e. f. g. h. Student Orientation Programming with High-Risk target groups Social Media Campaigns on Campus Bystander Intervention Projects Guest Lectures in Classes Presentations at Pan-Hellenic events Single Gender Programming Sexuality Education
49 Challenges and Obstacles for Campus Healthcare Providers to do Prevention Work 1. Lack of Time 2. Lack of Skill/Information 3. Discomfort in Discussing Sexual Matters 4. Lack of Privacy and Space 5. Pressure to See More Patients 6. Ability to Reach Target Students
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